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Audit of elective paediatric clinic referrals from primary care February 2002-September 2006
Neil M Walker1, Nicholas J Ward, Robert H Richards
1Queen Alexandra Hospital, Cosham, Portsmouth, UK.
Insights
Paediatric orthopaedic Waiting List Initiative clinics effectively managed referrals, with most children discharged after initial consultation. Guidelines improved referral quality, minimizing inappropriate cases and workload for other specialties.
Area of Science:
- Pediatric Orthopedics
- Healthcare Management
Background:
- District general hospitals face challenges managing paediatric orthopaedic referral waiting lists.
- Waiting List Initiative clinics were introduced to address these challenges.
Purpose of the Study:
- To audit paediatric orthopaedic referrals and assess the impact of Waiting List Initiative clinics.
- To evaluate referral quality against local primary care guidelines and quantify associated workload.
Main Methods:
- Prospective audit of paediatric orthopaedic referrals.
- Comparison of received referrals with established local primary care guidelines.
- Analysis of pathology, investigations, disposal, and inter-specialty workload.
Main Results:
- Variations in normal development were the most common referrals, with most patients discharged after initial consultation.
- Few inappropriate referrals were identified, indicating guideline adherence by referring physicians.
- Waiting List Initiative clinics managed referrals efficiently but increased workload for other specialties.
Conclusions:
- Paediatric orthopaedic Waiting List Initiative clinics are effective in managing referrals and improving patient flow.
- Local guidelines enhance referral quality, reducing inappropriate consultations.
- Strategies are needed to mitigate the increased workload on other hospital specialties due to these clinics.
Abstract:
Our large district general hospital organized additional Waiting List Initiative clinics for paediatric orthopaedic referrals. A prospective audit examined pathology, investigations and disposal, and the implications of Waiting List Initiative clinics, particularly the increased workload for other specialties and disciplines. Variations of normal development were the most common presenting complaints, with the majority discharged following initial consultation. Local protocols, providing guidance to primary care physicians, covered common paediatric orthopaedic problems. We compared these guidelines with the referrals received to establish the referral quality and quantify the extra work generated. Few examples of inappropriate referrals were found, suggesting that referring physicians utilize the guidelines.
